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[Rachatkinson]

Hi I’m on oestrogel ( 2 pumps) and utrogestan ( 1 tablet) and recently have been  using ovestin ivaginal cream.
 I am getting heavy bleeds every 2 weeks- I have had a scan and everything is alright there. Back to see my GP ,  she told me to try upping my oestrogen to 3 and maybe 4 times a day and that should stop the bleeding . She then seemed to doubt herself ( said something like - have I got it the right way round) but then was definite to increase the oestrogen. I am now confused as about 6 months ago a different GP told me to up my progesterone ( couldn’t tolerate that) . Is it the ratio of oestrogen to progesterone that matters re bleeding?
Adding in the ovestin cream has definitely made the bleeding heavier, but I’d like to continue with it as it helps my bladder.

[Nas]

Hi there 

Usually it’s the progesterone which requires tweaking, where bleeding is concerned.

Increasing the oestrogen, has the potential to make the bleeding worse, unfortunately.

Are you taking 100mg utrogestan daily or 200mg for a number of days each month?

How long were you period free, before you started the HRT? Usually you need to be at least one year with no period, before introducing a continuous progesterone regime.

There are also other types of progesterone to try, which may help control the bleeding better.

Hopefully some of the other members will be along soon, to share what has worked for them.

[Rachatkinson]

I’m on 100mg utrogestan daily no break . I’ve been on HRT since I was 37 ( now 60) as no pituitary function. I was doing ok with tablets and having a bleed , but then I had a DVT and switched to continuous and had bleeding problems getting worse ever since. That was about 7 yrs ago.  I’ve tried a few different sorts because of supply problems and the gel and tablet suit me well apart from the bleeding side of things.

[Penguin]

Sounds like you need to increase your utrogestan and / or decrease your estrogen- I'd try one first and then the other so you know which has had an impact. However, I'd also go back to the GP, maybe trying to see a different GP if possible,  given yours seems a little inexperienced in HRT advice.

[Rachatkinson]

Yes, thank you, I think I’ll decrease the oestrogen - when I tried to up the progesterone previously it gave me a stinking headache and blocked nose.
Yes I need to go back to the GP - unfortunately we seem to be getting a stream of locus, so it’s a bit unpredictable who you see.

[Penguin]

You could try to use the utrogestan vaginally, a number of women on here (me included) do that to reduce the side effects.

[Inky]

Yes, my consultant (BMS also say this) told me that on higher doses of estrogen (in  my case 75 or 100 mg patches), higher doses of Utro can be recommended. If you are going to use it vaginally, you need to take the same amount as you were taking orally (ie one a day), not half the dose (ie one every other day) as I think Louise Newson recommends. When I took it every other day vaginally it led to PM bleeding.

[Rachatkinson]

Thanks, I think I’ll I’ve that a go 🙂

[Cassie]

You could try and decrease your gel to 1 pump a day and the utrogestan vaginally 100mg I would not increase the oestrogen gel it will make things worse.

[Bungo]

Could she take 100mg.orally and the other 100mg progresterone vaginally? That would minimize side effects